Wishes for Wildlife Auction Donations

Organization Name

First Name^*

Last Name^*

Email Address^*

Street Address^*

City^*

State ^*
AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareWashington DCFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennslyvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming

Zip Code^*

Phone (Day)^*

Phone (Evening)^*

Item being donated^*

Stated value ($)^*
(Fair market value, as determined by the donor, required for tax deduction.)

Description^*
(Clearly describe your donation, including dimensions, color, material, etc. This description will be used to provide information for the auction catalog.)

Special Instructions/Restrictions*
(i.e., expiration dates, blackout dates, location of service, or any other special instructions or restrictions.)

Display
(Please provide ideas or indicate if you will send materials, brochures, etc., that would best showcase or represent the donation.)

Website or Link
(If applicable, please provide a website address or link for people to learn more about your donation)

Who is your primary contact at Liberty Wildlife?^*

Item delivery^*
—Please choose an option—I will deliver the item to Liberty WildlifePlease arrange for pickup

Gift certificate^*
—Please choose an option—Not RequiredWill be provided by donorCertificate to be provided by Silent Auction Committee

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